In recent years many invasive surgical and operative medical procedures have been developed utilizing videoendoscopic techniques. Videoendoscopy reduces the trauma and recuperative periods associated with prior conventional surgical techniques. Videoendoscopic procedures have been developed for a wide variety of gynecological, chest, abdomen and urologic procedures, to place feeding tubes into the digestive tract, to take biopsies, to inspect for tumors, and to correct some types of infertility, by way of example. Additional techniques may be developed including encloscopic techniques for sinus surgery, esophagus repair, fetal surgery and prophylactic breast cancer surgery. Videoendoscopy entails inserting instruments through a small incision into an operative cavity. A narrow video camera is also inserted to guide the surgeon in manipulation of the endoscopic instruments.
For example, operations which take place in the abdomen are carried out by inserting trocar stops through the abdominal wall and peritoneum. A trocar supplied with air or an inert gas is inserted into the trocar stop, and gas flow is commenced to inflate the peritoneum. Video cameras and instruments are then inserted through the trocars to carry out the operation. Unlike prior conventional techniques, the surgeon is not able to rely on his or her sense of feel and direct tactile response during endoscopic surgery. Further, visual response is limited to that viewed through the endoscopic video output, in which many structures may look similar. It is thus critical that surgeons are taught and maintain videoendoscopic skills that help them to identify structure and to carefully control the endoscopic instruments to ensure that a surgical procedure is accurately performed without causing unnecessary damage to surrounding tissue.
Many endoscopic surgeries require incision and dissection of tissue using electrocauterization. The endoscopic electrocautery scalpel serves as the cathode. The anode, or return electrode, is placed under the patient's back prior to surgery to complete the electrical circuit, and the scalpel is then used to cut and cauterize the tissue. Electrocauterization via endoscopy is a technique that also requires great skill and precision.
Conventional techniques for teaching endoscopic surgery procedures involve the use of animal specimens. The use of laboratory animals for surgical training is very expensive and is sometimes also subject to popular debate. Additionally, animal specimens have a short viability on the operating table, and thus provide the trainee with a limited period of time in which to practice repeated techniques.
As an alternative to conducting animal studies, a surgical training device referred to as a pelvic trainer has been developed that consists of a tray containing rigid synthetic organs. The tray is covered with a clear latex sheet through which endoscopic instruments are poked. While this device presents some opportunity to view the simulated organs relative to the operative instruments, these rigid plastic organs are not suitable for manipulation and dissection, and thus do not provide realistic training.
Other endoscopic training systems that are being developed involve virtual reality systems using robotics to mimic the mechanical feedback experienced by surgeons during endoscopic training. These systems are highly complex and expensive, and the reliability, accuracy and degree of realism provided by such systems has not yet been established.
There thus exists a need for systems and methods to train medical students and surgeons in endoscopic techniques that provide low cost realistic opportunities to practice videoendoscopic manipulation, incision and surgical procedures. In order to make this training most effective, trainees should be provided with realistic visual and tactile feedback during training.